G0252 prior authorization | Premera Blue Cross of Washington

G0252, PET imaging, full and partial-ring PET scanners only, for initial diagnosis of breast cancer and/or surgical planning for breast cancer (e.g., initial staging of axillary lymph nodes), is on the Premera Blue Cross of Washington prior authorization list. Not a coverage or referral decision.

Code: G0252
Description: PET imaging, full and partial-ring PET scanners only, for initial diagnosis of breast cancer and/or surgical planning for breast cancer (e.g., initial staging of axillary lymph nodes)
Source: Clinical Review by Code List PBCWA, Pg 683 Original policy

Premera Blue Cross of Washington prior authorization

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